- Select how you want to update existing values.
- No Update: Does not update any existing Encounter Allowed amounts.
- Open Period Only: Updates the Contracted Allowed Values for Encounters in the Period that is currently open.
- Open & Closed Periods: Updates all Contracted Allowed amount values for all Encounters even if the Period is closed.
- Select Save [F2].

Add a Procedure to an existing Fee/RVU Schedule
- Select the Fee/RVU Schedule Items number.
- Select the Add button.
- Enter the Procedure Code information and Fee.
- Select Save [F2].

Delete/Expire a Fee/RVU Schedule
- A Fee/RVU Schedule can only be deleted if it has not been used.
- Highlight the Fee/RVU Schedule.
- Select the Delete button.
- Enter a Reason.
- Select Save [F2].

- If the Schedule has been used, enter an Expiration Date instead.
- Highlight the Fee/RVU Schedule.
- The Delete button is grayed out.
- Select the Modify icon.

- Enter an Expiration Date.
- Select Save [F2].

- The Fee-RVU will disappear from the list.
- To see it again, select Include Inactive in the Filter Criteria.
Modify a Fee/RVU Schedule
- On the Fee/RVU Management screen, select the Modify icon.
- Make necessary changes and Save.
- Relative To Fee Schedules cannot be modified.
- All changes are made on the File that was chosen to be Relative To.

Modify Individual Items in a Fee/RVU Schedule
- Select the Items number on the Fee/RVU Schedule that you want to change.
- Use the Filters to narrow your search, if applicable.
- The Search function auto filters on the Key Word entered.
- Select the Modify icon on the left to modify the Modifier, Procedure Fee, Effective Date, and/or Expiration Date for an individual Procedure Code.
- Select Save [F2].
Modify the Fee/RVU Schedule on an Individual Item
- Select the Modify Icon on the right to make changes to the Fee-RVU Schedule.

Mass Fee/RVU Edits
Multiple Fees/RVUs can be updated at once.
On the Fee/RVU Management screen:
- Select the Items number on the Fee/RVU Schedule you want to update.

- Use the Filters to narrow your Search.
- Procedure: Multiple Procedures can be entered or a Range of Procedures
- Procedure Report Group: Multiple or a range of Report Groups can be selected.
- Use the check boxes to select the Procedures to update.
- Select the Mass Fee button.

- Increase By: Select Increase by Percent or Increase by Dollar.
- The percentages and amounts can be increased (using a positive number) or decreased (using a negative number).
- Round Up: Select one of the following:
- Nearest Dollar
- Nearest Dime
- None
- Select Save [F2].

Upload a File to Overwrite or Add to a Fee/RVU Schedule
An Existing Fee/RVU Schedule can be overwritten or added to by uploading a new file.
- Select the Modify icon on Fee/RVU Schedule.

- Source: Select Upload File.
- File: Select the New File.
- Overwrite:
- Select the check box to Overwrite the existing file.
- Leave unchecked to add to the existing file.
- Additional Procedures/Fees can be added to the existing file.
- If the Procedure Code already exists, the Procedure will be duplicated.
- Be sure the Procedure Code does not already exist on the Fee/RVU Schedule before saving.
- Increase By: Select Dollar or Percent.
- Enter Percent or Dollar Amount.
- Round Up: Nearest Dollar, Nearest Dime, or None.
- Select Save [F2].
- This cannot be undone after it is saved.

Fee/RVU Schedules in the Procedure Code Library
The Fee/RVU Schedules can be seen on the Procedure Code in the Procedure Code Library.

"Relative To" Charge or Allowed Fee Schedules
Relative To Charge Fee Schedules are not the same as RVU Fee Schedules.
The Relative To Charge or Allowed Fee Schedule mimics the associated Charge or Allowed Fee Schedule with the option to increase or decrease the Fee by a Percentage of Dollar Amount on the Relative To Fee Schedule.
- Using Relative To Fee Schedules can save time when creating new Fee Schedules for a new year.
- Creating a Relative To Fee Schedule copies the Charge Fee Schedule.
- A percentage or dollar amount can be added to increase or decrease the Relative To Fee Schedule.
- Changes made on the Charge or Allowed Fee Schedule are also reflected on the Relative To Fee Schedule.
"Relative To" Charge Fee Schedule Setup
Libraries > Fee/RVU Management
- Type: Select Charge Fee or Allowed Fee.
- Description: Enter a Description
- Source: Relative To
- Relative To: Select the Charge or Allowed Fee Schedule that you want this Fee Schedule associated with.
- Multiplier %: Enter the percentage or dollar amount that you want to increase or decrease the Fees that are on the associated Fee Schedule.
- This will increase the Fee on the Relative To Charge Fee Schedule by the chosen percentage or dollar amount.
- Example: To increase the Fees by 150%, enter 150.
- When the associated Fee Schedule is updated, the Relative To Fee Schedule will also be updated using the percentage or dollar amount that was selected.
Example of a Relative To Fee Schedule
- The Medicare Charge Fee already exists.
- A Relative To Fee Schedule is being created called BCBS Charge Fee Schedule.
- Percentage to increase: 100
- The BCBS Charge Fee Schedule is mapped to the Insurance where you want the Relative To Fee Schedule to be used.
- 99213 is entered on a BCBS claim.
- On the associated Medicare Charge Fee Schedule, the Fee is $150.00.
- On the Relative To, BCBS Charge Fee Schedule, the Fee is changed automatically to $300.00 because it has been increased by 100%.
Changes are made to the Associated Charge Fee Schedule
- 99213 is changed on the Medicare Charge Fee Schedule from $150.00 to $175.00.
- The Fee will be changed automatically on the Relative To, BCBS Charge Fee Schedule to $350.00.
Logic for Effective/Expiration Dates
The System chooses the Fee Schedule that is most specific for the criteria you have chosen on the Charges. This is driven by the Effective and Expiration Dates on the Fee Schedules, considering all other criteria are the same except the Fee amount.
- Example 1: Default Fee Schedule A has Effective and Expiration Dates of 01/01/23 to 12/31/23, and Default Fee Schedule B has an Effective Date of 01/01/24 with all else being the same except the Fees.
- A charge has a Date of Service of 06/15/24.
- The Fee Schedule the System will use is Schedule B because Fee Schedule A has an expiration date of 12/31/23, which is before the DOS of 06/15/24.
- A charge has the Date of Service of 11/21/23.
- The System will use Schedule A because the DOS falls between the Effective and Expirations dates of 01/01/23 and 12/31/23.
- Example 2: The same scenario exists as above, but there is another Fee Schedule C that is not the Default and is more specific than the Default.
- Schedule B & C have the same Effective Date of 01/01/24.
- Schedule C also has BCBS specified as the Insurance where as, Schedule B has ALL Insurances selected.
- Since the Insurance on the Charge is BCBS, the System will use Schedule C because it has Insurance specificity.
- Example 3: Schedule C has an Effective Date of 01/01/24, and Schedule D has an Effective date of 06/01/24.
- Schedule C has BCBS chosen as the Insurance.Effective Date.
Logic for Procedure Codes and Modifiers
- The Charge has a Modifier on the Procedure Code > The Charge Fee Schedule does not have a Modifier on the Procedure Code.
- The Fee will pull from the Charge Fee Schedule even though it does not have the Modifier.
- The Charge has a Modifier on the Procedure Code > The Charge Fee Schedule contains the Modifier on the Procedure Code
- The Fee will pull from the Charge Fee Schedule if the Charge matches exactly.
- The Charge has a Modifier on the Procedure Code > One Charge Fee Schedule does not contain the Modifier, and one Charge Fee Schedule has the Modifier and matches the Charge exactly.
- Considering all else is equal, the Fee will pull from the Charge Fee Schedule that has the Modifier.
- The Charge has a Modifier on the Procedure Code > The Charge Fee Schedule does not have the Procedure Code with the Modifier.
- The Fee will not pull from the Charge Fee Schedule and will be populated with 0.00 since there is no exact match.
Fee/RVU Management Table
The table shows all the Fee/RVU Schedules with the following columns.
- Description
- Type: This is the Type of Fee Schedule that was chosen when the Fee Schedule was created.
- Charge Fees
- Allowed Fees
- Work RVUs
- Facility RVUs
- Source: What was the source that was used to create the Fee/RVU Schedule?
- Hover over the blue entries to see the name of the File that was uploaded, copied, or is relative to.
- This is for informational purposes only. The original csv file is not stored in the System.
- Items: The number of items in the Fee/RVU Schedule.
- Billing Provider, Facility, Insurance, and Plan: Select the View link to see the included Providers, Facilities, Insurances, and Plans.
- Effective: Date the Fee/RVU Schedule started.
- Expiration: Date the Fee/RVU Schedule ended.
- Self Pay: A green check mark indicates if the Fee Schedule is being used for Self Pay.
- Default: The check mark indicates the Fee/RVU Schedule is the Default.

Validate a Procedure in Fee/RVU Management
If you want to see which Fee Schedule is being used for a specific Procedure Code, you can use the Validate feature in Fee/RVU Management.
Libraries > Fee/RVU Management button
- On the Fee/RVU Management screen: All 5 of the fields below must be selected.
- Select the Procedure Code.
- Select Type: Charge Fees
- Select a Billing Provider
- Select a Facility
- Select an Insurance
- The one listed in the blue banner will be the System's choice because it has the latest Effective Date.
- Example 1: Schedule A and Schedule B have an Effective date of 04/01/2023.
- Schedule A includes All Insurances, with ALL showing in the Insurance Column.
- Schedule B has BCBS specified with View showing in the Insurance Column.
- The Charge has BCBS chosen for the Insurance.
- Since both have the same Effective Date, the System will look for specificity.
- Schedule B is the most specific because it specifies because it species BCBS as the Insurance.
- Schedule A has an Effective date of 01/01/2024 and has BCBS as the Insurance.
- Schedule B is marked as the Default and has an Effective date of 08/31/2018 and has ALL Insurances selected.
- Even though Schedule B is the Default Fee Schedule, the System will choose Schedule A because it has a later Effective date.
Learn More
Update Existing Values